This is a 2-Center (80 subjects/Center) randomized, controlled trial of intensive therapy (IT) versus usual care (UC) in 6-16 year old subjects with IDDM for at least one year. Subjects will be randomly assigned to IT or UC and followed for 18 months. Health outcomes, psychosocial and family factors, and division of diabetes-care responsibilities will be assessed. After the randomized intervention, UC subjects will be offered IT for 6 months.